[Strategy and prospect of laparoscopic lymph node dissection for locally advanced upper-third gastric cancer]

Laparoscopic D2 lymphadenectomy for locally advanced upper-third gastric cancer(LAUGC) must follow the same lymph node dissection extent with open surgery. Following the surgical steps can make the operation process more smoothly and achieve en bloc resection. Laparoscopic spleen-preserving splenic hilar lymph node dissection is the difficult point during total gastrectomy for LAUGC. Selecting the right surgical approach, mastering spleen vascular anatomical types, and the cooperation of surgical team can help to shorten the learning curve of the operation. Although laparoscopic lymph node dissection for LAUGC is still in the exploratory stage, we believe that with the emergence of evidence-based medicine, it is expected to become one of the standard operations for LAUGC.